In modern times, we’re fortunate to have the ability to stabilize an injured patient and pass them to a higher medical resource. In survival settings, however, stabilization and transport may be next to impossible. Bleeding wounds are especially problematic and action is necessary to prevent a life-threatening situation.

Bleeding can be either venous or arterial. Venous blood presents as dark red blood draining steadily from the wound. Arterial bleeding is bright red (due to higher oxygen content) and comes out in spurts that match the pulse. Serious lacerations can have both.

The effect on the body caused by blood loss depends on the amount. The loss of 1.5 pints of blood or less will have little or no effect on the victim. Losing 1.5 to 3.5 pints will cause rapid heartbeat and respirations. The victim will become agitated while their skin becomes cool and pale. A loss of 3.5 to 4 pints results in a drop of blood pressure and the patient may appear confused and become lethargic. At this stage, their heartbeat is usually very rapid. If a patient loses over 4 pints of blood, they will appear very pale and may become unconscious. Their blood pressure will drop further while their heart rate and respirations decrease.
The patient is close to death.

Stop The Bleeding

When you encounter a person with a bleeding wound, direct pressure is the first course of action. Often, direct pressure on the bleeding area might stop bleeding all by itself. If you have them, put on medical gloves as these will help prevent contamination by a “dirty” hand. If there are no gloves, you can use a bandana or other barrier.

Compression of the “pressure point” for the injured area may decrease bleeding. Pressure points are locations where major arteries come close to the skin. Pressing on this area will often slow bleeding further down the track of the blood vessel. For example, there is a large blood vessel behind each knee known as the popliteal artery. If you have a bleeding wound in the lower leg, applying pressure on the back of the knee will help stop the hemorrhage.

If simple pressure fails to stop the bleeding, it may be appropriate to use a tourniquet. Excellent commercially made tourniquets include the CAT and the SOF-TT. Don’t be afraid to improvise—a bandana/stick combination will work in a pinch.

If help is coming, mark the time of the tourniquet’s placement on the patient. If it isn’t, the tourniquet should be loosened every 10 minutes or so to allow blood flow to uninjured areas and to determine whether the bleeding has stopped. Prolonged use of tourniquets, besides being quite painful, could cause compromise of an extremity due to loss of circulation.

For very heavy bleeding, the use of clotting powders such as Celox or QuikClot is acceptable. These products also come in “combat gauze,” which is a bandage impregnated with the powder. Splinting to immobilize the injured extremity is also helpful.

Fighting Infection

Once the major bleeding has stopped, further examination of the wound may be warranted. Flush out the wound gently with clean, drinkable water or a 1-to-10 povidone-iodine solution. This is called “irrigation.” Pack the wound tightly with bandages. If the blood was coming from the top of the wound, start packing there.

Now, cover the injury with a dry dressing. The Israeli Army developed an excellent bandage that is easy to use and is found almost everywhere survival gear is sold. The Israeli battle dressing applies pressure on the bleeding area for you.

A life-threatening injury can happen anywhere, but with these first-aid tactics you can help keep a patient alive in the face of a remote emergency.

This article was originally published in the SURVIVOR’S EDGE™ Winter 2016 edition. Subscription is available in print and digital editions here.

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